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Northern Nevada is home to some of the most gorgeous and pristine lakes in the country — but also some of the most unforgiving. Lake Tahoe water temperatures average 50 degrees in the summer, making the danger of hypothermia real and always present. Here are the signs, symptoms and ways to prevent cold water drowning. When we think of air temperature at 50 degrees Fahrenheit, it’s not all that cold. But when it comes to water that’s 50 degrees, there is no comparison. Immersion in cold water is life threatening and can happen within a minute. Taking the right precautions before entering the water can save your life. The 4 Phases of Cold Water Drowning 1. Cold Shock Response: This response affects breathing and happens within the first minute. An automatic gasp reflex occurs in response to rapid skin cooling. If the head goes below water, water may be breathed into the lungs, resulting in drowning. A life jacket will help keep your head above water during this critical phase. Additionally, hyperventilation, like the gasp reflex, is a response to the cold and will subside. Panic will make this worse, so the key is to control breathing. 2. Cold Incapacitation: This response occurs within the first five to 15 minutes in cold water. In order to preserve core heat, vasoconstriction takes place decreasing blood flow to the extremities to protect the vital organs. The result is a loss of movement to hands, feet, arms and legs. Unless a life jacket is being worn, the ability to stay afloat is next to impossible. 3. Hypothermia: Important to note, it can take 30 minutes or more for most adults to become hypothermic. So there’s time to take action and survive. Keeping panic at bay is critical, as you have more survival time than you think. Symptoms include: Shivering Slow and shallow breathing Confusion Drowsiness or exhaustion Slurred speech Loss of coordination Weak pulse 4. Circum-rescue Collapse: This experience can happen just before rescue and is not well understood. Symptoms range anywhere from fainting to death. Some experts believe an abrupt drop in blood pressure may cause this final stage of cold water drowning, post-rescue. Additional Cold Water Drowning Safety Tips and Helpful Resources Always wear a personal flotation device as well as a wetsuit or drysuit. Your personal flotation device is the most important piece of water safety gear. Try not to panic as the first phases will subside. Controlled breathing is to staying calm. Research suggests the body can withstand the cold longer than we think. The Heat Escape Lessening Posture (HELP) is a position which helps conserve energy if you’re wearing a personal flotation device. By hugging your knees to your chest, this posture helps maintain body heat for some time.

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Posture is important, but for those children diagnosed with scoliosis (spinal curvature) it can be a difficult issue. The Washoe County School District Student Health Services Department screens 7th grade students for scoliosis as growth spurts often reveal the condition and, if diagnosed early, scoliosis can stop progressing. We asked Michael Elliott, MD, head of the Department of Pediatric Orthopedics and Scoliosis to answer some frequently asked questions about scoliosis. What is scoliosis? There are many types of scoliosis: early onset (occurs before age 10), congenital scoliosis is when the bones of the spine do not form correctly, neuromuscular scoliosis which is due to children’s neurologic and muscle disease, and the most common is Adolescent Idiopathic Scoliosis. The term “idiopathic “ means the exact cause is unknown, although we do know it runs in families. This type of scoliosis occurs in 2-3 percent of adolescents and is mainly seen during their growth spurt. This is why middle school screenings are recommended. Both genders get scoliosis but girls are 8 times more likely to have their curves progress and become larger. What are the signs that my child may have scoliosis? A few signs for parents to watch for are: One shoulder might be higher than the other. One leg may seem longer. A hip may be higher or look more prominent. The waist may not look the same from side to side (asymmetry). The trunk or rib cage may be more prominent on one side or shifted. When they bend forward they may have a bump on their back. How is scoliosis diagnosed? It can be noticed by a pediatrician at a physical, school screening nurse, PE teacher or parents. Once the curve is suspected the child is usually referred to a pediatric orthopedic surgeon scoliosis expertise. At the initial visit the doctor will perform a thorough physical including a complete neurologic exam to assess the amount of curvature. Once the exam is completed the physician will determine if a spinal x-ray is needed. The curve on the x-ray is measured utilizing the cobb angle (a measurement in degrees) which helps guide the treatment. What are common treatments for scoliosis? The treatment depends on the size of the spinal curve and the amount of growth the child has remaining. An x-ray of the child’s hand is used to determine the amount of growth remaining. This allows the determination of the child’s bone age, and based on the hands growth plates it can determined if the child is in their rapid phase of growth. Treatments include: Observation - For curves less than 20-25 degrees. This entails visits every 6-9 months with a repeat scoliosis x-ray. Since scoliosis curves increase only 1-2 degrees per month, and variations in measurements can be 3-5 degrees, an x-ray is not recommended before 6 months. If the curve remains less than 25 degrees the child is followed until their growth is completed (usually age 16-18). Progressing Curve - If growth is finished and the curve is less than 40 degrees, the risk of more curvature into adulthood is small. If growth is completed and the curve is over 45 degrees, the child is followed for several years as these curves can progress into adulthood. If the patient is still growing and the curve has progressed greater than 25 degrees but still in the non-operative range (less than 45-50 degrees) bracing is used to stop the progression of the curve. Bracing - Indicated for curves over 25 degrees but less than 45 degrees. If a brace is required you will be referred to an orthotist (bracing specialist). The orthotist assesses your child, reviews the x-ray and then fits the brace. (Having a brace made usually takes 2-3 weeks.) Once the brace is fit, your child will visit the scoliosis specialist for an x-ray in the brace to ensure it fits correctly. The primary goal of bracing is to halt progression of the curve and prevent the need for surgery. The brace must be worn for about 16 hours per day to be effective. In a recent bracing study 72% of the patients who wore their braces as prescribed prevented the need for surgery compared to the group who did not wear their brace. Surgery: When a curve reaches 45-50 degrees, and a child is still growing, surgery is usually recommended because the curve is likely to continue progress. If a curve is over 50 degrees and the child is done growing surgery also may be recommended. This is because when curves are over 50 degrees they tend to increase 1-2 degrees per year for the rest of your life. As curves get larger the amount of lung function tends to decrease which could cause breathing problems later in life. The goals of surgery are to stop the progression of the curve and safely correct any misalignment. This is accomplished by attaching implants (rods, screws, hooks and bands) to the spine. Bone graft is then placed around the implants to encourage the spine to fuse (grow together). This then forms a solid column of bone with metal rods in place, preventing the curve from changing. Most patients are back to their regular sports and activities six months post surgery.

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Friday, April 12 is National Grilled Cheese Sandwich Day! So Let us help you create a healthier melt-in-your-mouth version to this popular cheesy sandwich. Ah, the grilled cheese. It’s the quintessential comfort food that not only pairs easily with a cup of soup, but it’s easy to whip together with just a few ingredients. There are many reasons to celebrate the gooey cheesiness of this toasted sandwich, but at nearly 700 calories, it’s definitely an occasional treat. But with just a few ingredient swaps — think light mayonnaise or toasting the bread in a toaster instead of slathering it in butter — you can remake your grilled cheese into a mouth-watering and nutritious meal. We’ve compiled a couple of easy substitutions, and some of our favorite healthy twists, so you can try a new variation of an old favorite. Be Choosy with Your Cheese It’s the star of your sandwich, but do you need to always grab the yellow slices? Try to opt for stronger flavors, like blue cheese or extra-sharp cheddar, to help you retain flavor while using less cheese on your sandwich. Better Bread Goes A Long Way Plain old white bread might be your toast of choice, but by choosing a whole wheat or multi-grain bread for your sandwich you’re not only adding in new crunch and flavor, you can also increase your fiber and nutrient intake. Hold the Butter Your mom, and maybe even your grandmother, probably spread a layer of butter on your grilled cheese throughout your childhood. But know this: It isn’t necessary. While butter helps crisp the crust, it doesn’t add too much in the way of flavor. Instead, brush the bread with olive oil, or try using a thin layer of reduced-fat mayonnaise or a creamy spread. Or skip grilling altogether by toasting your bread and then baking your sandwich open faced in the oven for a few minutes at 350 degrees. Healthier Options Looking for a new twist? Here are three incredibly tasty (and healthier) versions of the traditional grilled cheese sammy. 1. Baby Swiss And Tomato Grilled Cheese 2. Green Grilled Cheese 3. Spinach, Pesto & Havarti Grilled Cheese

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Bruschetta Chicken Bake is quick, affordable, and super easy to prepare on a busy schedule. The best part is that you don’t even have to pre-cook the chicken! Instead, serve this meal with a bagged salad and a crusty loaf of bread, and you’ll have a healthy, homemade dinner on the table in no time!

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Unfortunately, many in our community go to bed hungry. Thanks to the support of the Food Bank of Northern Nevada and other local partners, Renown’s food pantry is helping meet the food needs of homeless and low-income individuals in our community. Patients who qualify for the “Food is Medicine Prescription” can receive a bag of food for themselves and each member of their immediate family every week through a free assistance program. This project started last year when Renown began giving food support to hospital and emergency room patients who expressed the need. Food is also given out at the Healthcare Center, which provides affordable access to care for anyone in our community. Those who receive care at the Healthcare Center are also eligible for food assistance. Working Alongside the Community After receiving food deliveries from the Food Bank of Northern Nevada, Renown’s community health team collects an assortment of fresh produce, donated from local grocery stores and other community organizations. Then they put together one bag for each family filled with healthy foods, such as: Whole grain cereals Shelf stable milk Kid-friendly snacks (granola bars, popcorn, graham crackers Proteins (low-salt soups, stews, peanut butter) Seasonal produce Food is Medicine Prescriptions Continue Amidst the Pandemic Throughout the COVID-19 (coronavirus) pandemic, Renown’s community health workers have been working remotely. They continue to reach out to patients who need groceries from the Food is Medicine Prescription program. With this in mind, the food pantry staff is currently coordinating outpatient deliveries to those with a Food is Medicine Prescription. At present, Renown is working to get more refrigeration, shelving and staffing to expand the service to more Renown Medical Group patients in need of food.

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As many people search for diets to try to achieve weight loss resolutions, Kim Colegrove, Renown Dietary Educator, has all you need to know about one of the trendiest diets – intermittent fasting. What is intermittent fasting? Intermittent fasting is an eating pattern that switches between periods of fasting with no food or very restricted caloric intake, and periods of unrestricted eating. The diet has come into popularity as a way to help people lose weight without restricting what they eat, just when they eat. How does it work? The rationale behind intermittent fasting is that the pattern of eating promotes weight loss due to hormonal changes – namely, the decrease in insulin levels – as well as effects on your gut and overall decreased energy consumption. There are various schedules, including alternate-day fasting and time-restricted feeding. For example, one popular method involves restricting your eating period to eight hours per day and then fasting for the remaining 16 hours. Another requires fasting for 24 hours once or twice per week. What should people consider before they try intermittent fasting? Some people have found success in losing weight with intermittent fasting. However, it’s important to note that it’s not a diet that necessarily promotes sustainable habits and lifestyle changes. There’s also not enough research conducted that shows its lasting impact on health, weight, or metabolic improvement. For most, an intermittent fasting diet is just that – a diet. A person will likely lose weight because they consume fewer calories, but keeping the pounds off is an aspect of healthy weight loss that requires a permanent lifestyle change. Who should NOT try intermittent fasting? Intermittent fasting is not for everyone and it can pose a health risk to women who are pregnant or breastfeeding, people with diabetes, and children and adolescents in an active growth stage. Also, it would not be appropriate for those with a history of eating disorders, as well as people with certain health conditions that require them to eat every few hours. You should always talk to your doctor before beginning a restrictive diet such as this, especially if you have a chronic health condition or are taking certain medications.

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Rich, dark and super chocolaty, these sweet potato brownies are perfect for those following a paleo, vegan, gluten-free or dairy-free lifestyle.

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For most parents, convincing kids to eat fruits and veggies can be challenging, but they need good nutrition. We've provided six helpful tips to encourage healthy eating. 1. Make a Schedule Create a meal schedule and stick to it as much as possible. If you’re on the go, take a cooler stocked with healthy options to avoid stopping for fast food. However, many fast food restaurants offer healthy options like grilled chicken, chili, baked potatoes and protein-packed salads. 2. Kids + Kitchen = Fun! Children may be more inclined to eat what they’ve helped prepare. Bonus: it’s quality family time you can enjoy together while being productive. Find some healthy and fun recipes you can tackle as a team. 3. Dip It Introduce veggies by offering ranch dressing or hummus with fresh carrots, snap peas or broccoli. Experiment with various vegetables and dips to see what piques your child’s interests. Make it fun by cutting up veggies to resemble animals or exciting shapes. 4. Limit Unhealthy Food Buy smaller packages instead of economy bulk-sized options. Offer sweet treats but provide some nutrition — apple slices in light caramel sauce, bananas with peanut butter or strawberries in dark chocolate. 5. Provide Smaller Portions Scale portions appropriately for the child’s age and needs. For example, a preschooler generally would not require the same intake as their teen sibling. Ask your pediatrician about your child’s individual nutritional requirements. When they can handle utensils safely, allow them to serve themselves. This will help them feel like a “grown-up” and help them understand portion sizes. Encourage children to take one serving at a time and return for seconds only if they are still hungry. 6. Allow Treats Some say denying occasional treats will only make kids want them more. However, it’s OK to allow for an occasional treat as part of the big picture. You can also model good eating habits for your children. And remember: Just because you don’t like a particular food doesn’t mean they won’t. So expose your children to healthy foods — even if they’re not your favorites. Check out the recipe section of our blog for delicious recipes your family will love!

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Nutrition is a vital aspect of patient care. At Renown Health, the Food & Nutrition Services (FNS) teams take their mission of delivering patients high-quality, cost-effective, nutritious and attractive foods to the next level. From a thrice-daily trayline service with a wide variety of delicious food to the personalized dietitian services that ensure every patient gets the nutrients they need for optimal healing and recovery, Renown’s FNS teams at Regional, South Meadows and Rehab are unmatched.  Food for the Good Fight  The hustle and bustle of early morning food preparations gears the FNS team up to, as Renown Regional Food Service Worker Molly Kalsman puts it, “provide patients with adequate nutrition to heal.” From morning until nighttime, the team prepares three meals a day along with late trays and snacks.  This isn’t your run-of-the-mill hospital food, either. Think anywhere from cheeseburgers and salads to pork roasts and baked potatoes. As you can imagine, food of this caliber requires all hands on deck in the kitchen, especially during trayline times, to ensure all patients receive quality meals that meet their individual nutrition needs. “We make an impact with good service and great food,” said Mario Nunez, a Food Service Worker at Renown South Meadows.  As the food service workers are hard at work cooking and assembling, the nutrition representatives visit each patient to learn their individual dietary restrictions, allergies and food preferences. For Julie Macaluso, Nutrition Representative at Renown South Meadows, “letting the patients choose their meals” is one of the highlights of her job. “We go over meal choices for their stay, so the patient can pick out something they would like to eat and find enjoyable,” added Tara Sprehe, Nutrition Representative at Renown Regional.  The immense care and attention our nutrition representatives give to every patient paves the way for our clinical dietitians to build a nutrient-dense diet plan based on the individual patient’s preferences. Dietitians are the only licensed providers that can leverage nutrition to treat, manage and prevent illness and disease to improve patient outcomes. Every day, our experienced dietitians “make recommendations in the adjustment of macro and micronutrients in order to best manage a person’s health status in the setting of trauma, diabetes, heart disease and other morbidities,” said Jessica Blauenstein, a Registered Dietitian and Board-Certified Specialist in Oncology Nutrition at the William N. Pennington Cancer Institute. Overall, for this department, the phrase “that’s not my job” will never be heard, according to Lupe Ayala, a Cook at the Renown Rehabilitation Hospital. Day-in and day-out, it’s a massive group effort – and that’s the way they like it.  Setting the Service Bar High  Hitting milestones and accomplishments comes naturally to this crew. The FNS team sets the bar incredibly high for food and service standards across the Renown Regional, South Meadows and Rehabilitation hospitals.   The key ingredient? Synchronized teams that operate like a well-oiled machine. The meticulous trayline schedules and assembly lines, the cooks that put their heart into patient meals, the nutrition representatives and dietitians who ensure patient food wants and dietary needs are being met... the list goes on. And to top it all off, these teams certainly know the meaning of “service with a smile.”  Their efforts do not go unnoticed. “I am very proud of the team I have,” said Monica Lara-Yanez, Supervisor of Food and Nutrition Services at Renown South Meadows. “They have improved their knowledge and participated in cross-training, and they are very efficient doing their jobs and helping each other. Moreover, they care about the service we provide.”  One major accomplishment the FNS department achieved in recent years was implementing Room Service Connect, which aids in direct communication with patients, letting them know what foods are available to them during their stay at Renown based on their dietary needs. Locating trays of food has also never been easier. According to Tara Sprehe, “This system is also beneficial for letting food service workers know when a diet has been upgraded, discontinued, changed to NPO status or downgraded. This reduces the risk of giving the patient a diet that is not appropriate for them,” which saves both time and money for the department.  At the end of the day, the FNS department has one mission, and it’s the same mission we all employ as Renown team members: do it for the patient.  “It’s all about patient care,” said Jesse Holman, Cook Lead at Renown Regional. “That is the best accomplishment!”  A Dedication to Renown   The patients, the providers, and the passion: these are the most common themes that keep the FNS department passionate about Renown and their team. Whether they are just starting out in a career in food service or have established themselves in the clinical field, the FNS department proudly upholds the greatest standards of nutritional care that enhance Renown’s status as a top healthcare leader in northern Nevada.  “I choose Renown because it is a very distinguished institution with an amazing reputation, offering a lot of benefits and growth opportunities to employees,” said Monica Lara. “It makes me feel proud to say, ‘I work at Renown.’” Renown Rehab Food Service Worker Margretta Corbet echoes this sentiment, adding, “There are good people here with happy dispositions.”  Many FNS team members are especially enthusiastic about Renown’s robust benefits and career growth opportunities. For Molly Kalsman, working at Renown gives her the experience necessary to enter a career in dietetics. “Food service and hospital experience is encouraged to be accepted into a dietetics internship program, and Renown was the perfect opportunity for me to gain that experience,” said Molly. Carleigh Bates, Nutrition Representative at Renown South Meadows, is on a similar path: “Renown is a vehicle for so many things I am aspiring towards, such as getting my foot in the door for working in healthcare, improving the experiences of patients and gaining experience that will aid in my future goals.”  Carleigh emphasizes that the team’s commitment to Renown’s mission is at the core of what they do every day. “We impact patient care by providing nutrition to fuel their wellness and improve their stay.”  Lupe Ayala wraps up this strong conviction from the team very well: “I didn’t choose Renown; Renown chose me.”  Fight the Good Fight With Us This future-minded, patient-centric department is growing! The Food & Nutrition Services teams at Regional, South Meadows and Rehab are actively hiring eager, collaborative new team members. Natasha Frisbie, FNS Lead at Renown Regional, reports that the team has “successfully hired and trained 24 new employees in the past three months” and is still expanding. “Teamwork, communication, and enthusiasm are very valuable skills to have in this department,” said Molly Kalsman.   If you or anyone you know is looking for their next growing career opportunity, apply today!

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Excess amounts of sodium doesn’t just increase your risk of a heart attack, it can also increase your risk of a stroke. Unfortunately, avoiding that saltshaker may not be enough. Did you know that the average American consumes 3,400 milligrams of sodium each day? That’s a dangerous number considering that the American Heart Association recommends limiting daily sodium intake to 1,500 milligrams (about half the weight of a penny) to reduce the risk of heart disease and stroke. The problem is not necessarily that you’re putting too much salt on your food, it’s that salt is already in the foods you’re regularly eating. To help keep your sodium intake at a healthy level, make sure you’re aware of “The Salty Six,” six sneaky foods that are surprisingly high in sodium. Breads, Rolls and Tortillas: Although breads and tortillas may not initially appear to be high in sodium, we often consume several servings. Make sure to keep track of your total servings to see how they add up. Deli Meat, Cured Meats and Poultry: It may surprise you that six thin slices of deli meat can add up to more than half of your daily limit, so be mindful when building those sandwiches. Also, do your best to avoid cured meats, which often means the meat has been salted. Substitute uncured, skinless meats instead. Cheese: Salt is an important addition in the cheese-making process, as it prevents bacterial growth. Unfortunately, that added salt can increase your health risks. Limit the amount of cheese you add to meals to keep your sodium content down. Pizza: Take a quick look at the first three items above and it should be no surprise as to why pizza made the list. One slice and you’ve met at least half of your daily limit. Go easy on the cheese and try adding more veggies instead of meat. Canned Soup: One cup of canned soup can be as high as nearly 1,000 milligrams of sodium. When shopping for canned soup it’s important to check the label – not just on sodium content but serving size as well. Always select low-sodium options when possible or cook your own soup at home. Sandwiches and Burgers: A sandwich or burger from your favorite restaurant can contain more than 100 percent of your daily sodium limit. When dining out, it is best to select low-sodium options or eat a half portion to limit the amount of salt. If some of your favorite foods are on this Salty Six list, don’t panic. Although these foods can be high in sodium, it isn’t necessary to cut these foods out of your diet completely. It’s just important to eat them in moderation and be mindful of your daily sodium intake. Look for low-sodium options, use herbs and spices instead of table salt and do your best to stay under the recommended daily limit of 1,500 milligrams.”

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